FDA: Infant Circumcision… to detect hemophilia?

Contraindications to newborn circumcision
include significantly premature
infants, those with blood dyscrasias,
individuals who have a family history of
bleeding disorders[...]” -
AAP – Technical Report on Circumcision, 2012

A recent FDA article about treatments for hemophilia, quotes doctor Nisha Jain, M.D., chief of the Clinical Review Branch in FDA’s Office of Blood Research and Review, saying:

“Patients can be diagnosed as infants during circumcision”

Dr Nisha Jain, M.D

Dr Nisha Jain, M.D

The problem with this though is that these patients may die as a consequence of the bleeding caused by their circumcision. These deaths often go unreported. Babies are not tested for hemophilia prior to circumcision.

In March of 2013, baby Brayden Tayler Frazier was transferred to UC Davis Medical Center, Sacramento, CA, because he wouldn’t stop bleeding after his circumcision. He later went to seizures and finally died, 2 days later. His death was not reported on the media, and it was only because of activists scanning social media for circumcision-related topics, that the intactivist community learned of and followed this tragedy.

After the death, doctors and family were in denial that circumcision had anything to do with his passing. He had been sick, they argued. His initial sticks and pricks didn’t heal as quickly as normal, and yet in the face of this telltale sign, the circumcision was performed. It would be hard to deny that the massive bleeding that followed led to the catastrophic outcome.

Baby Brayden was treated with coagulants, platelets, plasma, everything to try, unsuccessfully, to save his life.

Another known victim was Ryan White (1971-1990). Again, his circumcision caused massive bleeding and so he was detected to be hemophiliac. In his case, it wasn’t the bleeding though what killed him, but the medication used to treat it;  weekly transfusions of Factor VIII,  a blood product created from pooled plasma of non-hemophiliacs, infected him with the HIV virus. He died from AIDS related complications.

That Dr. Jain thinks it’s fine to detect hemophilia on infants during circumcision is a disrespect to babies like Brayden and others who died from loss of blood and other related clotting disorders and conditions after their unnecessary and unethical circumcision.

Finally, only in the United States will doctors enable parents to risk their children’s health in the name of a social surgery. See this paper by Kuthan Kavakli et al, arguing that “Hemophilic boys (60%) and their parents (82%) have an inferiority complex because the boys are unable to be circumcised” – notice how the dissatisfaction of parents was higher (82%) than that of the boys (60%). Kavakli concludes that “circumcision is an important social problem of hemophilic patients that needs to be solved.

A social problem indeed, and rational minds wonder why not solve it with education. Maybe that is too much to ask.

 

 

4 thoughts on “FDA: Infant Circumcision… to detect hemophilia?

  1. The lead author of “Should hemophiliac patients be circumcised?”, Kuthan Kavakli, is identified in the abstract linked to as being associated with Ege University in Turkey, and although not specified in the abstract, it is likely that the study was undertaken amongst a Turkish population.

  2. Great article. It might be cosmetic but I’m not sure you can call Factor VIII “a medicine manufactured using human blood”, since Factor VIII is naturally present in human blood. Maybe it would be better to write “weekly transfusions of Factor VIII, which is derived from donated human blood, …”.

  3. A while ago I attended a course in thrombosis and hemostasis. One class was about hemophilia. Today, if you are diagnosed with hemophilia you can make it into your 60′s or 70′s. Also, thanks to biomedical advancements you don’t need any more to store transfusions in the refrigerator and treatment has become cheaper and more accessible. So, hemophilia should not be any more an accepted reason for death, but rather the cause of the bleeding should be given as the reason for death, like circumcision in the case of Baby Brayden.

    Another thing to mention is that hemophilia, which is the malfunction or lack of an important blood coagulation factor, Factor VIII, is on the rise for unknown reasons. Also, it is a disease that affects mainly boys because Factor VIII is encoded in the X chromosome of which males have only one. So it you are male and inherit an X chromosome from the mother that has a defect in the gene encoding Factor VIII, you will have hemophilia. Girls have a much lower chance since they have two X chromosomes and they both would have to be defective for a girl to have hemophilia. Since hemophilia is on the rise and it affects mainly boys, we might unfortunately see an increase in circumcision related accidents. Hopefully, the rates of circumcision will go down fast enough.

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